Tuesday, January 31, 2012

Why My Husband will Never Write a Fashion Blog

Five stylish guys, writers of what the NY Times calls "Macho Blogs," graced the cover of the Style section several days ago. Each one gets hundreds of thousands of page views monthly and each allows men who like looking sharp to discuss fashion with a manly slant.

Not his actual jeans...but close...
My husband won't be reading any of their blogs, much less writing one (he's busy posting plenty on politics and pop culture) not simply because he's removed from the cutting edge of style. To the contrary, he's on the jello-edge of style.

Were I to post photos of his outfits every day, many people would gain great amusement, chuckling.

They'd see his unnoticed spots on faded shirts, his failed meal-napkin attempts to clean others.  They could admire off-brand Dockers-wanna-bes frayed at the bottoms. Corduroy worn shiny and smooth. Flannel shirts with pocket flaps curled, super-comfortably large, tucked into his belt, cinched at his belly button.

We've always affectionately called him sartorially-challenged; he says he's merely relaxed.

Attempts to correct or improve the situation are regularly rebuffed. Our daughter made a Nordstrom Rack run, returning with presentable jeans and pleas to wear them a bit lower than his midriff. But why try on new jeans when his nicely broken-in ones, with threadbare knees, serve so well?  The man works in radio, remember.

Shirts his size are cast off as "too constricting."  And why pay for bland, solid-color t-shirts, when he's got stacks of freebies splashed with garish promotional slogans?

We begged him to change one Sunday before a family outing--when he was clad in a roomy royal blue t-shirt with the name of a not-well-received cable talk show embroidered on the front in canary yellow. He declined.

Beside his two dozen t-shirts touting failed movie titles, he's got a collection of organization button-downs with logos so embarrassing, he's tried to camouflage the advertising by pulling out threads, creating a peek-a-boo look above the pen-pocket.  On one shirt, his attempt to obliterate the company name led him to transform it into a "tan school".

His philosophy is that like fine wine, remnants of which can be found on his shirts, clothes in general improve with age.  He will not part with sentimental reminders of his life decades ago, and indeed, my collection of photos through the years shows him with babies, toddlers, grade-school kids and high schoolers, our same three children, aging in his beloved (also aging) shirts.  In middle school, he wore the same sweatshirt to school every day, and it's still in his drawer.

Do not believe that I could sneak into his wardrobe while he's at work for some discarding and renovation. That would bring a similar reaction to my re-arranging his stereo equipment, and hell hath no fury like a funkily-dressed audiophile.

Perhaps the most famous story about his penchant for casual attire regards an invitation to meet with President George W. Bush in the White House. For the occasion, he wore a sport jacket, white shirt, tie, and black jeans. His best black jeans, of course.

After the meeting, former drug czar William Bennett, also in attendance, took my husband aside. In a kindly, gravelly whisper, he said, "When you meet with the President, it's customary to wear a dark suit." If only my husband would own a dark suit.  Well, there is the one from his Yale graduation, that he still pulls out when necessary.

After 27 years of marriage, I've come to accept my husband's idiosyncrasies as charming. I don't connect my own self-esteem to his appearance, and the fame of his nonchalance about clothing often leads our hosts toward low expectations.  Our children, however, are tenacious in nudging him toward respectability, lending credence to the Skinnerian notion that intermittent reinforcement is most difficult to extinguish.  Occasionally, my husband, upon their urging, will pitch a wholly holey shirt.

He'll condescend to their insistence because he knows there's a rack of frayed-collar alternatives still beckoning in his closet, mellowing with each passing day.

Sunday, January 29, 2012

Junk Food in Schools Doesn't Affect Childhood Obesity--Despite New School Meals Regulations

Just catching up on the newspaper and came across two items that show that all the tax dollars and excitement funnelled into curbing childhood obesity goes largely to waste. Both appeared in the New York Times--one reports on a study that compares students in schools that sell junk snacks with kids whose schools didn't, and it followed the ones who moved from one type of school to the other.

The second item was a front-page story discussing the merits of bariatric surgery--stomach stapling or banding to reduce the amount that can be consumed--for obese teenagers. It followed 17-year-old New Yorker Shani Gofman through the process until she was 20, and along the way weighs the pros and cons of this type of obesity treatment.

Both suggest the same conclusion: Childhood obesity rates won't respond to conventional, ie current (expensive, extensive) efforts to to lower them.

Results of research at Pennsylvania State University about the effects of junk food in schools are especially pertinent this week as the White House, in concert with the USDA, announced its new regulations for the food content of school breakfast and lunch programs. The rationale for this aspect of Michelle Obama's $4.5-billion, 10-year Healthy, Hunger-Free Kids Act is that tweaking the formulation of foods required for school meals will make kids thinner and therefore healthier, as well as model menus they'll emulate later.
What Michelle Obama ate at Parklawn Elementary when announcing the new school lunch requirements Jan. 25, 2012

That's kind of the idea behind replacing sugary, salty snacks sold in school vending machines with healthy alternatives. To see if this made any difference in middle and high-schoolers' girth, sociologists looked at students' longitudinal profiles, following them in and out of "competitive food environments" (ie schools with vending machines selling junk food). They also investigated whether gender, socio-economic status and race/ethnicity played into the vending machine-obesity issue.

Answer: No. Children's BMIs had no relationship to any of those factors. The study's lead researcher, Jennifer Van Hook, said, "Food preferences are established early in life. This problem of childhood obesity cannot be placed solely in the hands of schools."

Ahh, but those are the only hands the Feds can control.  So they've now constrained local schools' freedom to decide what's good and feasible for their populations.  And what are these enlightened changes?  Not much, except now lunches will have more.  More fruits and veggies specifically, moving from a half-cup to a cup of veggies per meal, for example, (with types of veggies now specified) and adding to that same tray a half-cup of fruit.  Starting this year, half of bread stuffs will be whole-grains, moving to all whole-grain by July 1, 2014. And no more whole milk allowed; low fat only.

The feds know adding all these extra requirements is expensive, so they've agreed to spend six cents per meal of your tax dollars to subsidize the changes.  If you look at the USDA's comparison of what those menus look like compared to the old ones, you'll see--there's basically just a lot more food.

Take any menu they offer as an example--say, Tuesday. The old, supposedly obesity-producing lunch offered: Hot Dog on a Bun with ketchup, 1/4 cup canned pears, raw celery and carrots (1/8 cup each), 1.75 tablespoon ranch dressing, and 1% chocolate-flavored milk.

Now look at its superior replacement:  Whole wheat spaghetti with 1/2 cup meat sauce, a whole wheat roll, a half-cup of cooked green beans, a half cup raw broccoli, a half-cup raw cauliflower, a half-cup kiwi halves, 1% milk, an ounce of low-fat ranch dressing, and 5 grams of soft margarine.

Think of how eagerly those elementary school kids will be gobbling up all those cooked green beans, and that raw broccoli, cauliflower and those coveted kiwi halves! The children's delight in two cups of greens, perfectly complimenting their (whole wheat) spaghetti, will surely create little fiber-philes who will happily eschew (and not chew) the candy and baked goods youthful generations before them have craved.

I am impressed that federal nutritionists think schools can deliver kiwi halves, not to mention cauliflower, for a mere 6 cents extra per plate.  Peeling the fuzz off kiwis is going to add substantially to preparation costs.

Michelle Obama eats at Parklawn Elementary, Alexandria, VA
The second news story that convinces me that well-meaning efforts to curb childhood obesity are doomed describes Shani Gofman's experience with "laparoscopic adjustable gastric banding," a surgery that limited the size of her stomach.  She weighed in on the day of her operation at 271 pounds, a BMI of 51.  Two weeks later, she was down 20 lbs, and after six months reached 237 lbs.

Then she graduated high school and took a summer Israel tour with a group of her peers.  She "would wolf down her food and then she would run to the bathroom to vomit or sit in pain waiting for it to make its way through the band." About nine months after surgery, she'd gained back half of what she'd lost.  Even enduring the pain and discomfort of surgery does not guarantee that a motivated teen can conquer obesity.

"Most of us have witnessed the medical establishment provide the same advice over and over again to kids who are overweight--they just need to diet and play more outside," said University of Cincinnati pediatrician Thomas Inge. "I wish it were that simple."

And that's the point. It's not as simple as whole grain rolls or even cutting into a young woman's abdomen to shrink her stomach.  The wrongly-named "obesity epidemic," a phenomenon that began in 1980 and peaked in 2000, is complex.  There's precious little concrete data to explain it, and every effort to turn it around has failed. Why, for example, have obesity rates remained at the same (high) levels for the past ten years? Perhaps instead of throwing more money and regulations at this broadening target, it would be prudent to pull back and see exactly what's going on.  Better to deal with the difficulties of obesity--health, emotional, financial, inter-personal--on an individual basis, where compassion and tailored solutions have at least some chance of bringing improvement, if not cure.

Thursday, January 19, 2012

Snow-mageddon in Seattle

The record snowfall here in Seattle is all over the news, partially because it's just so weird.  Snow is squeal-inducing for kids who get out of school and can spend the whole day making snowmen, sledding hills and sipping hot chocolate, but not so much fun for adults required to get from here to there, either slipping on icy pathways or skidding in circles on streets and freeways.

Our family has endured a nearly comical series of weather-related events that inspire gratitude for the normalities of life.

A few days ago, we learned that our main water line from the meter to our home had sprung a massive leak. In the process of digging a trench for the replacement pipe, a worker clipped our phone line.  Then the snows came.

At first we marveled at the winter wonderland, confectioner's sugar dusting the firs and piling on our patio furniture. But soon it became serious, as five, six inches of snow caused the closing of schools, canceling of classes, curtailing hours at businesses and the gym. Our temporary water pipe was subject to freezing. I could no longer navigate my non-four-wheel-drive Mom-car up the hill to get out; as temperatures cooled and re-froze, dangerous ice accumulated on the ground.

Our son, ticketed for a visit home on his college break, spent five hours in the airport due to plane cancellations into Seattle. My husband, due at an important business meeting near LA, found his 6 am flight cancelled as he drove--five miles per hour--to the airport; I spent 40 minutes on hold with the airline (on my cell phone--our land lines were cut, remember), which never did get to me.

Then, the power went out.  The house chilled colder by the minute with no furnace. I prayed my cell phone would retain enough juice.  But it's almost relaxing to be stuck, even if bundled in many layers of down--can't use the computer (no router)--a good excuse to catch up on reading. Until 4:30, when it gets dark.

When things go wrong, you get grateful for what's right. While without water for days, brushing teeth and cooking meant sparing sips and drips from bottles only. Flushing a toilet was suddenly a wonderful luxury; washing hands afterward, an issue.  Taking a shower was something done at somebody else's house.

No power in freezing weather means wearing enough to mimic the Michelin Man. You put  refrigerator contents outside, where they'll stay cold. Days later you find splotches of wax on counters and floor from the candles you've carried from room to room. You wonder how civilizations managed until the 20th century.

We were very fortunate and, thank God, safe. My husband never went to his meeting, but somehow his boss and colleagues got along without him.  We were able to ride in an all-wheel-drive vehicle to friends who had electricity. Our son's flight eventually made it, and after several hours, our power returned. The yard is decorated by a snowman, and about seven inches of crunchy snow have collected on our driveway.  School's off again tomorrow, and we have a week to remember.

Wednesday, January 18, 2012

Why Childhood Obesity-Fighting Programs Fail, and What they Should Do

A front-page story in today's New York Times business section laments the lack of effective obesity-fighting programs for children. Many such programs have sprung up, in true entrepreneurial style, since the Obama health care law mandates reimbursement for obesity screening and counseling for children.  The trouble is, these conventional-wisdom Kool-aid-slurping approaches are going about it the wrong way.

Calories in equal calories out?  Family awareness about "good" versus "bad" foods? Encouragement to exercise?  These have comprised kids' school health programs since the 1960s.  Weigh-ins and group therapy? The article is accompanied by an adult peering over the shoulder of a chubby pre-teen to read the numbers on a scale.  Does this warm-hearted and well-meaning supervision inspire a lean life?

There's no data supporting long-term positive outcomes for any of these programs, and indeed, for any of the thriving diet industry offerings for either adults or children.  Knowledge doesn't bring long-term skinniness, even if will-power and "simple adjustments" slice off a few pounds. "If this were easy, if there were clear outcomes for success, we would be investing in these," confesses Dr. Samuel R. Nussbaum, chief medical officer for a huge health insurer.

You can bet more and more of these anti-fat education programs will proliferate, as long as big butts bring big bucks. But from the research I've been conducting for a book on the topic, they'll add to the national deficit, perhaps bring some short-term shape shrinkage, but won't return our population to slimness levels of past decades.

That's for two reasons. First, the shape of Americans has changed, and shoehorning Americans back into their sizes of yesteryear will be akin to putting toothpaste back in the tube.  Average height has enlarged from 5-foot-six, which was the mean for men at the turn of this century, (a figure that fluctuated since 1700 reflecting disease as well as nutrition) to  5-foot-ten among Americans born here in 1970. The National Center for Health Statistics reports that in 2006, the average height for all American males (including immigrants) was 69.2 inches, a little over five-foot-nine. It's a major body expansion, but nobody is campaigning to reverse growth in that direction.

At the same time, bodies have ballooned outward. A CDC study found that between 1960 and 2002 the average weight of a man aged 20-74 rose from 166 lbs. to a more portly 191 lbs. Women similarly enlarged, from 140 lbs. to 164.  In those same 42 years, life expectancy rose from age 66 for men and 73 for women (1960) to 75 for men and 80 women today (2010).  Hmmmm. We're getting taller, fatter and living longer. Correlation does not imply causation.

And we're adjusting to our increased proportions. An article in the NY Times discussed "the New Calculus of Broader Backsides," as Transit Authorities replace their subway and train cars.  Perhaps in honor of its governor, New Jersey Transit, the piece noted, has increased its seat width from 17.55 inches to a comfortable 19.75 inches. Connecticut Metro-North Rail Commuter Council chair Jim Cameron was most pithy in his approving self-interest: "Why subject my girth to other people?"

Yes, we all want to protect our girth, which is exactly why all these lauded weight-reduction programs are doomed to failure. Everybody's fat, including our icons like Oprah and Rush Limbaugh, and with a fourth of the nation (35% of blacks) self-reporting themselves obese (perhaps underestimating a bit?) "fitting in" means to a size 14 average for women--and those sizes have themselves become more, uh, roomy.

The second, and more crucial reason for the failure of these earnest efforts to stem childhood obesity (which in the past three years has leveled off, by the way) is that their tactics are wrong.  Most big programs, like WellPoint, involve dietitians who instruct on creating healthy low-calorie meals, limiting portions and choosing wisely. Does this sound enticing? Exciting?

How about the programs where participants weigh in in front of an authority? Just what kids want to do. Weight Watchers tried a web-based course for youth that they scuttled "after discovering children were regaining their weight after a year, with some even gaining more than they might have had they not participated."

There's an elephant in the room, and it's not just the collective tonnage of overweight children.  It's the fact that we don't truly know what makes people obese, and we haven't found any way--other than obsessive, life-long restriction and vigilance--to keep people thin once they lose weight. It's not a simple equation of calories in, energy out, as Tara Parker Pope wrote quite eloquently in a New York Times Magazine cover story a couple of weeks ago called "The Fat Trap." You see, there are a raft of hereditary and biological forces that not only conspire to bulk us up but to maintain fat on human bodies. She disclosed that exercising and eating properly haven't allowed her to lose the 60 extra pounds on her frame. Her research revealed that they're apparently programmed to stay there.

Telling that to pudgy kids and their families won't inspire much hope, however, and won't get them leaping onto the "Let's Move!" bandwagon. Instead, institutions and companies eager for Obamacare dollars mislead audiences into thinking their diets and measurements can solve the problem. "What we're learning about treating childhood obesity is that there is no magic bullet in dropping weight in kids," admits Roanoke, Virginia pediatrician Dr. Colleen Kraft, who's affiliated with the WellPoint program that tried.

We know that about 19% of children aged 6-18 are obese, but it's tougher to find the percentage that are morbidly obese, of whom Randy Seeley, associate director of the Obesity Research Center at the University of Cincinnati Medical School says in Time Magazine, "zero percent will grow up to be normal-weight adults."  Googling "morbidly obese children" only yields hundreds of articles discussing the merits of snatching these kids out of their biological parents' homes into foster care--for their own good, of course.

If taxpayer-paid programs can't reverse childhood obesity despite financial incentives, what can we do? That desperate question underlies a progressive value that assumes intervention--anything--is required for every problem. Given that science has yet to understand whether it's DNA, stress, or even an adenovirus that has spiked rates of obesity over the past 20 years in both children and adults, it's naive to assume more instruction that repeats mandatory school health lessons about square, uh, pyramidal, uh plate-shaped diets combined with exercise, will work.

What will work is dropping all the federal funding in this squeezed economy for spongy, feel-good programs with no basis or track-record. Scale back on the school breakfasts and lunches, even the ones with the salad and apples designed to model healthy meals (that end up in the trash). Keep the health courses that offer basic nutritional information but focus not on some mythical ideal dinner plate but instead on learning what real hunger and satiation feel like, and why listening to those physical (and associated mental) cues--rather than emotional needs and ubiquitous come-ons of fast food and supermarket munchies--is the way people stay naturally healthy and in sync with their bodies.

At this point, until science catches up with some definitive information, we also need to discuss and to some extent embrace the reality that overweight (not obesity) is actually the most healthy status. Paul Campos, in his book The Obesity Myth documents that greatest longevity accrues to those in the "overweight" BMI category. In an interview in The Atlantic, Campos, a law professor at the University of Colorado, Boulder, says "There is literally not a shred of evidence that turning fat people into thin people improves their health. And the reason there's no evidence is that there's no way to do it."

Do we want healthy Americans, or do we want fashionably thin ones? With Michelle Obama's chisled biceps as models, used as she gracefully shovels dirt for the White House vegetable garden, it seems the latter.  There's no harm in recognizing healthy foods and activities, but insisting that over-riding our own intuitive means to know what's healthy for us individually, and what's satisfying to us physiologically, eliminates the most time-tested and simple means to stay our personal best weights, whatever the number on the scale.

Friday, January 13, 2012

Denying a Hershey's Kiss to live longer

"How much of what you're denying yourself is because you think you're increasing your life expectancy?" asked Rush Limbaugh on his radio show today.

He was discussing the fact that Prof. Chris Semsarian, a cardiologist in Sydney, Australia warned that energy drinks can trigger dire effects when consumed by young people who may not be aware of an underlying heart problem, or when followed by "a trip to they gym." The actual message of the doctor was prudent, but Rush was pointing out how news media ran with the story, headlining that "energy drinks 'can trigger heart attacks'" to satisfy reader/viewer hunger for anything that can prolong your life.

This story comes at the same time that the research "showing" that reservatrol, found in grapes and wine and touted to help the heart and slow aging, was found to be largely based on faked data. A 60,000 page report documents 145 "counts" of fraudulent data in the work of Dipak K. Das of the University of Connecticut's Cardiovascular Research Center, much published in peer-reviewed journals and the basis of the marketing of dozens of supplements.

People will latch onto anything "experts" say increases longevity or helps avoid serious illness.  Whether it's adequately proven or not.  At one time, I took 400 international units of Vitamin E every night, because the consensus was that this antioxidant could prevent cancer, Alzheimer's and heart problems--a consensus that has since been discredited. Before that was the Linus Pauling Vitamin C craze to prevent colds, since abandoned.  Now Vitamin D is the big fad, once again as a preventative to a raft of dreaded diseases, most notably cancer. The National Institutes of Health's exhaustive review, however, summarized, "Taken together, however, studies to date do not support a role for vitamin D, with or without calcium, in reducing the risk of cancer."

There are certainly some things that will enhance risk of death. Smoking, for example, though thousands of people have smoked like chimneys and had no ill effects, and some have even suggested that seeing our President--who earlier this year announced he'd finally quit--taking a drag might humanize his image.  Evel Knieval's jumping a motorcycle over lines of 20 cars might be considered a risky, "death-defying" habit, though he died from diabetes and a lung condition.

Mothers all over the world have admonished children fleeing the house sweaterless that they'd catch their death of cold, even if they'd taken enough Vitamin C to impress Linus Pauling.  The list of risks is limitless; might even be a pretty funny book.

But back to the quote I heard on the radio today that rang so true: How much of what you're denying yourself is because you think you're increasing your life expectancy?  In other words, how much do you deprive yourself of simple joys, or even more complex ones, out of fear induced by some "health" news story? I know someone who won't savor a Hershey's kiss because she's sworn off sugar, considering it "toxic."  I don't buy that one, and now, thankfully, the "experts" are saying the flavanols in dark chocolate provide anti-oxidants that validate my daily fix.

Since I'm immersed in writing a book whose underlying point is "to thine own self be true," regarding what your body tells you, I embrace the notion that our lives are too short and precious to over-ride its personal messages and pleasures.  If we just tune in to the activities and tastes that make us feel strong and satisfied, we're likely to be pursuing our individual best paths to health.

I asked my Aunt Bo, 105 years old and living in sin with her 104-year-old boyfriend, Frank, the secret to their longevity.  They replied in unison, "Keep breathing!" They both used to smoke, when it was popular. They both enjoyed their highball cocktails. They have great stories to tell...but they never took Vitamin C or D or went to the gym.

We don't really know much about what prolongs life best, or avoids this or the other disease, but if every day contains some pleasure, some discovery, some joy in this awesome world, it's a day of gain.  Certainly some effort and discomfort can pay off in health benefits, but at the same time, chronic deprivation, especially when it feels like a sacrifice, won't bring the quality of life that is more important than its mere quantity.